How Many Deployments Is Too Many?
After my last, year-long deployment, I took to running. I was never a runner before, and to be honest, I did it as a promise to my wife. We wanted to share in an activity that we both could enjoy. Admittedly, I did not enjoy this activity at first. As I continued to add on the miles, I found that running provided me a therapeutic effect. I could allow my mind to wander. I could think. Running became my time to rejuvenate.
Running also became a time to learn about footwear. I thought I could do shoes on the cheap, and I could use the same pair of shoes until I wore out the soles. As I continued to increase the miles, my body told me my theory was incorrect. My hip started to hurt. I experienced plantar fasciitis. My knees would ache. I learned the hard way what many runners already understood: Shoes wear out, and if you don’t replace your shoes on a regular basis, your body will absorb more and more of the force and begin to break down. This is normal. Hence the pain.
The brain responds to chronic, high levels of stress in a manner very similar to the running shoe. With the shoe, it is a function of physics. With the brain, it is a function of chemistry and biology. When exposed to high levels of stress – as in multiple, combat deployments – the brain responds and adapts over time. When the stress is elevated, constant, and repetitive, the circuitry in the brain adjusts to accommodate. Because the brain is subjected to a constant state of fight or flight, the system becomes more chemically and biologically efficient at responding to these stressors. We favor the emotional side of the brain, and it becomes physiologically difficult to engage the rational side of the brain. The body, spirit, and mind suffer the consequences through pathologies like PTSD, anxiety, and emotional or otherwise related mood disorders. This is normal. Hence the pain.
How Do We Solve These Overuse Problems?
With my running shoes, I learned to count my miles. I know that for every 350-500 miles, the padding in my shoes becomes worn. If I want to prevent injury and keep my entire body healthy, I need to change shoes. But when it comes to deployments, when do we know enough is enough? How much can the chemistry and biology of the brain handle? Some studies already suggest that a service member is 3 times more likely to suffer PTSD from their second deployment. What happens when we get to three deployments? How about five deployments? The military programs of behavioral and mental wellness require the service member to volunteer to get help. At what point do we acknowledge that the service member needs help whether they volunteer for it or not? Furthermore, at what point are we willing to say that the service member has done enough deployments?
As the military gets smaller and smaller, we rely on fewer service members to do more. Fewer ships and Air Force squadrons requires fewer service members to spend longer periods away from home to support our global interests. The Army is deploying stateside units to Europe and Korea regularly to meet our strategic obligations. And, of course, we have ongoing operations to combat terrorism around the world in places like Afghanistan, Africa, and Iraq. I appreciate the fact that the frequency, intensity, and duration of the deployment matter, and I have learned the physiological impact to the brain over time is also normal. If we except this as normal, then we should demand more responsive systems in place to assess and meet the needs of our service members and their families:
- Mandatory Behavioral Health Counseling and Therapy. For Soldiers returning from deployment, let’s get past the screening. Let’s move beyond the surveys we complete as quickly as we can so we can get home to our families. Let’s acknowledge up front that all service members at a certain point will ABSOLUTELY REQUIRE assistance. Take the decision authority out of the hands of the service member (whose judgment is already impaired due to the condition of chronic stress). Because the decision is not their own, there is no stigma. By making everyone go, nobody is isolated or ostracized. You bring the resources to all of them.
- Deployment Limits. We have a bad habit of continuing to rely upon the same service members over and over again to do the difficult jobs away from home. After so many deployments, service members should be disqualified from future deployments (national emergencies being the obvious exception). Yes, I know – they will want to go. I heard it all the time. That is the problem. After a while, they feel more comfortable being at war than they do being at home. Unfortunately, they may physically come home, but their mind will remain in a constant state of deployment.
- Approved Disability Ratings Based on Type, Duration and Intensity of Deployment. Why do we wait until a problem presents itself before we acknowledge the service connected disability to ensure health coverage for the Veteran? If the impact on the brain is normal, and we acknowledge the treatments necessary to heal, why are they not automatic? Why do we need to go through a problematic, long, bureaucratic system to prove what we already know from the science?
We don’t do these things now because of two issues: cost and readiness. It costs money to provide the psychologists, social workers, and therapists to provide the support our service members need – and our institutions are desperately short of these resources already. True, everything has a price tag, but why do we always seem to find the money to send them to war without considering the cost and consequences incurred to bring them home? Limiting deployment has some significant national security implications. Consider what the deployable force structure of our nation might look like if you disqualified from deployment all service members who have spent 36, 48, or 60 months deployed. Before you address that issue, consider the alternative of sustaining an all volunteer force without these precautions in place i.e. would you allow your son or daughter to sign up knowing these behavioral conditions were – dare I say – inevitable? These are not easy issues, but as we learn more about how the brain responds to repeated high, sustained, and intense levels of stress, we cannot deny the chemical and biological outcomes. We see the results in numbers of Veterans who struggle with PTSD, sleep disorders, anxiety, and suicide.
We can be proactive. The process of rejuvenating and healing the brain is as necessary as cycling the running shoe. Over time, the body, mind, and spirit suffer the consequences of continued wear from sustained stress. We already know how often runners should change their shoes, but we don’t know how many deployments are enough. We do know that we need a process for healthy transition – our objective at Stop Soldier Suicide, and perhaps that is the best way to address each of these issues. Will we ever know how many is too many? Unfortunately, the health of our Veterans and their families in the coming years will let us know when we have reached and surpassed that point, the same way a runner experiences a degenerating hip or chronic foot injury. At that point, the cost and the pain becomes undeniable.
This doesn’t need to be normal, because the pain to our Veterans and their families becomes unbearable.